Author: All Pediatrics

ALL Pediatrics will begin a Contactless Payment Service on October 1, 2021. We are excited to provide this innovative service for our families.

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Our December calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting Friday Aug 27th.

Please be aware while searching for an appointment that we are not scheduling well check appointments the last two weeks of December. During the holiday weeks we like to keep our schedules open for sick children.

I had hoped not to have to keep writing these, but circumstances have mandated a further update.

In pediatrics, we are used to the concept of rewarding children for good behaviour.  For example, telling your children when you go on a trip in the car, that if they behave, they can get a treat later.  However, if they don’t behave, and squabble in the back seat, then you are not going to figure out who was responsible, the ruling will be that nobody gets a treat.

The same situation applies to adults being vaccinated.  If everybody who could get vaccinated did, then we would all receive a treat:  no more mask wearing.  However, too many adults didn’t go along, COVID returned with a vengeance (although still not as bad as at its peak in most places), and we lost our treat:  back to mask wearing, even if vaccinated, in many, if not all situations.

Moving on to a subject that has nothing whatsoever to do with adults acting liked spoiled children, I turn to Florida, and Governor DeSantis.   He has declared that no school system in the state can mandate mask wearing. This is despite his state having more new cases and hospitalizations than at any previous period during the entire pandemic.  Public health issues, and the safety of children, are unimportant compared to the right to infect as many people as one wants.  This is not just a Florida issue, however; it impacts on us as well, since it is the underimmunized and maskless states that have fueled the resurgence of COVID-19 in this country, including in Virginia.

How do I feel about going back to school in light of the upsurge in cases?  Schools are vitally important, not just for academic learning but for social learning as well.  On-line learning doesn’t cut it; one does best with an in-person teacher (so I am also comfortable with home schooling, especially if one can find a co-op where all the parents have been vaccinated).  I want children back in school, and if that means wearing a mask for now, so be it.  There will of course be breakthrough infections, but one thing we have learned is that children generally have done well during the pandemic.  They tend not to get very ill.  Furthermore, when there are cases in a classroom, there have rarely been other children infected, and when children do get infected, it is most often from family members.  We also know, contrary to when the pandemic first hit, that the virus is transmitted from people, not objects, so your children are not going to catch it from sitting at a desk someone else used before them.

Cafeteria eating is a concern in schools.  As above, I am not concerned about picking up COVID-19 from a table.  However, masks are off when eating, and social distancing is a problem. I would prefer that children eat in their classrooms with prepackaged meals such as sandwiches, but that is not always doable.  Cohorting children (not mixing classes) as much as possible is preferred.   Enforced handwashing/ hand sanitizing before and after meals should be done.  As the lesser of two evils, I still vote for school with cafeteria eating rather than no school.

Of course, if your child is eligible for a vaccine (12 years and up for now, hopefully expanding to younger children soon). I recommend they get it, even at the risk of side effects, which are much less than those of the disease itself.

For example, consider the risk of Guillain-Barre syndrome from the vaccine, and assume that risk is 1 in 100,000 (it appears to be lower), and furthermore assume that everyone who gets it dies (although almost nobody does).  If we vaccinated every adult in the US, we would expect almost 3000 deaths from this, which sounds terrible, until you compare it with the 600,000+ deaths so far from COVID-19 itself –   a reduction in death of 99.5%.  The vaccine is of course not 100% at preventing infection, but it is highly effective at preventing hospitalization and death, which is why more deaths are now occurring in younger (unvaccinated) adults, rather than in sicker, older, but vaccinated, ones.

People sometimes wonder if they can trust the CDC, since it changes its recommendations often.  This is not flip-flopping.  Medical science adjusts as knowledge and conditions change, and what was true at one point may not be true at another.  Thus, we used to use penicillin for ear infections, for many years, but no longer, as it is ineffective.  This is not because we were wrong in using it 50 years ago, but because the germs have mutated, and we had to adjust our approach accordingly. Similarly, when COVID-19 cases were dropping, it was reasonable to ease up on mask wearing (although I personally never stopped wearing them in stores), but with the resurgence masks again have become an essential component to handling the pandemic.  One thing science can do well, when it is functioning properly, is to acknowledge change, rather than digging in its heels and refusing to face facts, as new facts emerge.

Hopefully, my next blog will be with good news about the pandemic, which has gone on for much longer than it needed to.

Our November calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting Thursday July 29th.

Our October calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on July 1st.

Our September calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on June 1st.

Things have been moving since my last update.  COVID-19 is still out there, of course, but the country’s weekly cases and death rate are finally back down to where they were in October. (To put that in perspective, we are still seeing over 300,000 new cases each week, and around 5000 deaths per week).  We still need to be sensible and wear masks in stores and try to socially distance, wash hands well, etc., but we can be more liberal about socializing, especially if all the adults have been immunized.   Thus, if the adults are immunized and healthy, visiting family such as grandparents can be back on, even if it involves a flight, in my opinion (but there are no 100% guarantees, of course).  I’ll be travelling myself later this month (but I personally am still holding off on indoor dining and movies).

I have been all in favor of going back to school, and look forward to camps with outdoor activities being open this summer.  The number of cases of children getting sick remains quite low, in particular for severe illness, and when they do catch COVID, it is almost always from family members, not classmates.  Beach vacations should also be fine; social distancing is not that hard on a beach, although it may mean being back a bit from the shore.

The big news is vaccinations, of course.  These have been game changers.  Most people do not have side effects, and when they do, they are almost always minor. Even the ones that have been publicized, such as blood clots, are small in number; the risk of a serious COVID infection if you skip a shot is orders of magnitude larger.

Should 16-18 year olds be vaccinated?  It’s not even close in my opinion.  Wherever you can get this done, do so.  We will be getting vaccines in our office very soon, and will start booking appointments. There may be some difficulty with the process as we roll it out at first, but please be patient as we work out the kinks.  We are told there will be ample supplies, so watch our website for further updates.

The next group up will be 12-15 year olds, for whom I expect approval shortly.  Again, I strongly encourage immunization for this cohort as well. I know that the physicians in the practice will be vaccinating their children this age.  I would do so for mine, but they are older and fortunately have already been vaccinated.

One note about the vaccines: until we have more data, it is recommended that no other vaccines be given within two weeks of the COVID vaccine, so if your child is due for others as well, you will need to schedule separate visits for those.  To lay out a time frame, if your twelve year old gets their required meningitis, tetanus and HPV vaccines on day 0, they would wait until day 14 for the COVID, then until day 35 (three week space between vaccines) for the second one, and then until day 49 if any more vaccines were needed.  If you wanted to do the COVID first, we can adjust the schedule for that as well.

Get vaccinated if you can, stay safe, and have a great summer!

Our August calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on May 4th.

Our July calendar is now available for booking online.

Book your appointment directly from our website by clicking here.

You may also use the patient portal or Healow app.

It will be available over the phone starting on April 15th.